Findings published recently in the journal Pediatrics reported that the number of at-risk children – or those with relatives who have celiac disease – who go on to develop celiac disease seems to be increasing. And recently, Dr. Renata Auricchio, from the University of Naples Federico II in Italy, set out to understand why this might be the case.
Studies have pointed toward infections in childhood as a potential trigger of celiac disease in those who are genetically susceptible. For instance, a 2013 study found that the presence of rotavirus antibodies could predict the onset of celiac disease.
Similarly, in the Norwegian Mother and Child Cohort Study, children who had experienced 10 or more infections before reaching the age of 18 months had a significantly increased risk of developing celiac disease than children who had had four or fewer.
Many earlier investigations into infections and celiac disease relied on parental recall of infections and have included a general cross-section of the population. However, to gather more detailed information, the new study used a prospective cohort. In other words, the team studied a group of infants known to be at risk of developing celiac disease and followed them for 6 years.
As the authors explain, the study’s aim was “to explore the relationship between early clinical events (including infections) and the development of CD [celiac disease] in a prospective cohort of genetically predisposed infants.
Across the study, 6 percent of the children were diagnosed with celiac disease at the age of 3, 13.5 percent at age 5, and 14 percent by age 6. They also found that “[c]ompared with gastroenteritis, respiratory infections during the first 2 years of life conferred a twofold increase in the risk of developing CD [celiac disease].”
When discussing how early infections might impact the later development of celiac disease, the authors write:
“It is possible that […] early infection stimulates a genetically predisposed immune profile, which contributes to the switch from tolerance to intolerance to gluten.”